On 30th March 1842, Dr Crawford Williamson Long excised one of two tumours from the neck of a Mr James Venable under sulphuric ether anaesthesia. He had rendered his patient insensible via an ether-soaked towel. Some medical students and several other onlookers watched the operation. At first, Dr Long's patient could scarcely believe what had happened. Only when he was presented with the half-inch-diameter cyst did Mr Venable realise that a tumour had been removed. His bill for two dollars itemised the cost of the ether as well as the tumour excision. On 6th June, Dr Long excised Mr Venable's second tumour. Other pain-free operations on different patients under ether anaesthesia followed. The procedures included the removal by Dr Long of a toe, a finger and another cyst.
Dr Long was an unlikely medical revolutionary. The son of a successful planter and merchant, he studied at Franklin Academy, later to become the University of Georgia. As a freshman, he first met his lifelong friend Alexander Stephens, the future vice-president of the Confederacy. After graduating from University of Pennsylvania’s Medical Department in 1839, Long served his hospital internship in New York City. At school, he both witnessed and took part in laughing gas parties and ether frolics. In those days, the stigma of "drug abuser" was not attached to anyone who wanted either to share the fun or conduct empirical research. Long noted the insensitivity of the participants to pain from bumps and bruises - at least until the nitrous oxide or ether wore off.
After his training in New York, Dr Long returned to Georgia in 1841. He took over a rural medical practice in Jefferson, Jackson County. As well as performing minor surgery, Dr Long delivered his wife's second baby with the aid of ether anaesthesia, a year before Professor James Simpson's better known introduction of obstetric anaesthesia in Britain. He also performed a painless dental extraction. Dr Long never sought to hide what he was doing, whether in surgery, dentistry or obstetrics; but he was not a publicist, nor was he avid for fame and fortune.
Uncertainty nonetheless persists over why Dr Long delayed publication of his groundbreaking innovation until 1849, over two years after William Morton's celebrated Massachusetts demonstration, and well after anaesthetic use in surgery had swept around the world.
Dr Long was a cautious man. He performed control experiments:"Surgical operations are not of frequent occurrence in a country practice, and especially in the practice of a young physician; yet I was fortunate enough to meet with two cases in which I could satisfactorily test the anesthetic power of ether. From one of these patients, [Mary Vinson] I removed three tumors the same day; the inhalation of ether was used only in the second operation, and was effectual in preventing pain, while the patient suffered severely from the extirpation of the other tumors. In the other case, [Isam] I amputated two fingers of a negro boy; the boy was etherized during one amputation and not the other; he suffered from one operation and was insensible during the other." [Long, C. W. (1849). An account of the first use of Sulphuric Ether by Inhalation as an Anaesthetic in Surgical Operations. Southern Medical and Surgical Journal, 5, 705-713]Local neighbourhood physicians were sceptical of his innovation. Dr Long did not want to serve up another version of Mesmerism [see Crawford W. Long’s Discovery of Anesthetic Ether: Mesmerism, Delayed Publication, and the Historical Record; Roger K. Thomas, Ph.D. The University of Georgia, Presentation in the Key Barkley Symposium on the History of Psychology, Southern Society for Philosophy and Psychology, April, 17, 2003, Atlanta, GA.]. For as Dr Long explained:
"At the time I was experimenting with ether there were physicians in high authority and of justly distinguished character who were advocates of mesmerism, and recommended the induction of the mesmeric state as adequate to prevent pain in surgical operations. Notwithstanding thus sanctioned, I was an unbeliever in the science, and of the opinion that if the mesmeric state could be produced at all, it was only on "those of strong imaginations and weak minds", and was to be ascribed solely to the workings of the patient’s imagination. Entertaining this opinion, I was the more particular in my experiments on etherization."In a claim unlikely to be repeated today, Dr Long states "...I was determined to wait a few months before publishing an account of my discovery to see whether any surgeon would present a claim...prior to the time it was used by me." With touching faith in the integrity of medical scholarship, Long waited to receive due recognition for his discovery. It never came in his lifetime.
Crawford Long died of a stroke in 1878. He had just administered ether to a woman in labour.
Crawford W Long
Refs and Further Reading
Anaesthesia and Anaesthetics